A nurse is caring for a client who has type 2 diabetes mellitus and reports blurred vision, numbness in feet and has had a wound on the right leg for the last 2 months. The clinic nurse notes that the client's Hemoglobin A1C is 8.19%. Which of the following should the nurse include in the client's plan of care?

A. While the client may eventually require insulin, the immediate focus is on understanding the meaning of the elevated HbA1c and current complications. Starting insulin is a treatment decision that the provider determines; it is not the educational priority in explaining symptoms. B. Fluctuations in blood glucose can occur, but the key issue here is chronic hyperglycemia, as reflected by an HbA1c of 8.19%, which indicates consistently elevated blood glucose over the past 2–3 months. C. Excessive exercise is not a cause of chronic hyperglycemia or diabetes-related complications such as neuropathy, retinopathy, or delayed wound healing. D. An HbA1c of 8.19% indicates that the client’s blood glucose has been above the target range (typically <7%), leading to chronic hyperglycemia. Symptoms such as blurred vision, peripheral neuropathy (numbness in feet), and poor wound healing are complications of prolonged high blood glucose. This explanation helps the client understand the relationship between blood sugar control and their symptoms, which is essential for education and self-management.